Article Figures & Tables
Figures
- Figure 1:
Flowchart for cohort of home-visiting physicians from Jan. 1, 2019, to Dec. 31, 2019.
- Figure 2:
Lorenz curve of home visits and home-visiting family physicians, from Jan. 1 to Dec. 31, 2019, in Ontario, Canada. This curve was generated by rank-ordering family physicians by their volume of home visits, then plotting the cumulative percent of physicians (x-axis) against the cumulative percent of home visits (y-axis).
Tables
- Table 1:
Characteristics of physicians, practice patterns and patient characteristics for the high-volume home visit physicians (top 5%) compared with low-volume home visit physicians (Jan. 1–Dec. 31, 2019)
Characteristic High-volume home visit physicians
n = 330Low-volume home visit physicians
n = 6242SMD* Physician characteristics Physician age, yr, median (IQR) 51 (38.0–61.0) 50 (38.0–60.0) 0.04 Self-reported physician gender, female, no. (%) 121 (36.7) 2887 (46.3) 0.20 Canada medical graduate, no. (%)† Yes 196 (59.4) 3768 (60.4) 0.02 Missing 61 (18.5) 1228 (19.7) 0.03 Physician urban or rural practice, no. (%)‡ Large urban 181 (54.8) 2689 (43.1) 0.24 Medium urban 89 (27.0) 1606 (25.7) 0.03 Small urban 49 (14.8) 1299 (20.8) 0.16 Rural 10 (3.0) 616 (9.9) 0.28 Missing 33 (0.5)** – Physician medical home enrolment, no. (%) 213 (64.5) 5301 (84.9) 0.48 Physician compensation model, no. (%) Capitation 45 (13.6) 1370 (21.9) 0.22 Team based ≥ 35 (≥ 10.6)** 1950 (31.2) 0.50 Enhanced fee for service 127 (38.5) 1924 (30.8) 0.16 Fee for service 117 (35.5) 941 (15.1) 0.48 Other 60 (0.9)** 0 Physician-level home visit volumes and payment, median (IQR) No. of home visits 477.5 (346.0–813.0) 9 (2.0–28.0) 2.58 No. of unique home visit patients seen 126 (79.0–240.0) 5 (2.0–12.0) 2.50 Patients seen per day on a day doing home visits 3 (2.0–5.5) 1 (1–1) 3.09 No. of home visits per patient 4.1 (2.4–6.4) 1.6 (1–2.5) 1.20 Home visits income (% total billing) 31.5 (16.6–51.6) 0.9 (0.2–3.4) 2.22 Home visits that are off-hours, %§ 17.9 (3.8–84.5) 16.7 (0–66.7) 0.27 Physician-level home visit patient characteristics Median patient age, yr, no. (%) < 18 110 (1.7)** 0.13 18–39 199 (3.0)** 0.13 40–64 42 (12.7) 696 (11.2) 0.05 65–79 115 (34.8) 1637 (26.2) 0.19 ≥ 80 157 (47.6) 3616 (57.9) 0.21 Patients aged ≥ 65 yr, %, median (IQR) 82.4 (61.6–95.1) 96.3 (70–100) 0.66 Median patient health care resource utilization band, no. (%) Low (0–2) 0 122 (2.0) 0.20 Moderate (3) 38 (11.5) 1109 (17.8) 0.18 High (4–5) 292 (88.5) 5011 (80.3) 0.23 Patients in a lower-income neighbourhood, %, median (IQR) 46.4 (30.7–57.1) 37.5 (3.8–71.4) 0.23 Patients in a large urban area, %, median (IQR) 66.4 (1.9–97.2) 6.3 (0–100.0) 0.29 Recent immigrant patients, %, median (IQR)¶ 0.2 (0–2.0) 0 (0) 1.19 Home visits made to patients who are enrolled to them personally, %, median (IQR) 0.3 (0–50.1) 75 (0–100.0) 0.93 Home visits made to their own or to their group’s enrolled patients, %, median (IQR) 4 (0–56.3) 87.5 (28.6–100.0) 1.12 Patients previously known in the prior 2 years, %, median (IQR) 72.3 (34.1–94.0) 100 (80.0–100.0) 1.13 Patients not in a medical home, %, median (IQR) 27 (18.8–41.1) 2.2 (0–29.8) 1.03 Home visits made to patients who received ≥ 2 home care visits in the previous 30 days, %, median (IQR) 53.9 (32.1–82.0) 60 (28.1–87.1) 0.08 Home visits that were palliative, %, median (IQR) 7.1 (0–95.8) 3.8 (0–50.0) 0.30 Home visits that were neither home care nor palliative, %, median (IQR) 42.6 (1.2–66.6) 29.4 (0–61.5) 0.10 Note: IQR = interquartile range, SMD = standardized mean difference.
↵* Standardized mean differences greater than or equal to 10% (0.1) are considered meaningful.
↵† Data from before 2014 are pulled forward where possible; however, this variable is not available for physicians who joined the College of Physicians and Surgeons of Ontario after 2014 (~25% missing in this data set).
↵‡ Rurality Index for Ontario score cut-offs were as follows: 0 large urban, 1–9 medium urban, 10–39 small urban and ≥ 40 rural.
↵§ ”Off-hours” was defined as a visit occurring between 5 pm and 7 am on weekdays or anytime on Saturday or Sunday and public holidays.
↵¶ ”Recent” was defined as within the past 10 years.
↵** Cells adjusted or combined to prevent reidentification of groups of < 6 individuals.
- Table 2:
Characteristics of physicians who provided office visits and no home visits, compared with low-volume home visit physicians (Jan. 1–Dec. 31, 2019)
Characteristic No. (%)* SMD† Low-volume home visit physicians
n = 6242No home visit physicians
n = 8186Physician age, yr, median (IQR) 50 (38.0–60.0) 46 (36.0–57.0) 0.21 Self-reported physician gender, female 2887 (46.3) 4083 (49.9) 0.07 Canada medical graduate‡ Yes 3768 (60.4) 4292 (52.4) 0.16 Missing 1228 (19.7) 2257 (27.6) 0.19 Physician urban or rural practice§ Large urban 2689 (43.1) 4346 (53.1) 0.20 Medium urban 1606 (25.7) 2295 (28.0) 0.05 Small urban 1299 (20.8) 1038 (12.7) 0.22 Rural 616 (9.9) 480 (5.9) 0.15 Missing 32 (0.5) 27 (0.3) 0.03 Physician medical home enrolment 5301 (84.9) 3992 (48.8) 0.83 Physician compensation model Capitation 1370 (21.9) 915 (11.2) 0.29 Team based 1950 (31.2) 898 (11.0) 0.51 Enhanced fee for service 1924 (30.8) 2102 (25.7) 0.11 Fee for service 941 (15.1) 4194 (51.2) 0.83 Other 57 (0.9) 77 (0.9) 0 Note: IQR = interquartile range, SMD = standardized mean difference.
↵* Unless stated otherwise.
↵† Standardized mean differences greater than or equal to 10% (0.1) are considered meaningful.
↵‡ Data from before 2014 pulled forward where possible; however, this variable is not available for physicians who joined the College of Physicians and Surgeons of Ontario after 2014 (~25% missing in this data set).
↵§ Rurality Index for Ontario score cut-offs were as follows: 0 large urban, 1–9 medium urban, 10–39 small urban and ≥ 40 rural.
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